e-KYC

Full Name *

NID *

Father's Name

Mother's Name

Email Address *

Phone *

Date of Birth

Photo (Image Upload)

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Permanent Address *

Present Address *

Order/ Invoice ID

Registration Type

NID Front (Upload)

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NID Back (Upload)

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I do hereby declare that the information and data given above are correct. In case of any false information, I shall be liable to appropriate legal action and I shall abide by the overleaf terms and conditions. NEXA PBX shall have the right to disconnect, suspend or bar the services for giving false information on the subscription form and/or for changes in the given information, which is not informed to NEXA PBX. NEXA PBX shall have the right to ask for documents and examine the same to establish the subscriber’s identification. Any Illegal activity with this service will have to bear clients personally. NEXA PBX has nothing to do against Government rules.

*Please avoid any illegal activities with this IPT number

I agree

e-KYC Form

*Please avoid any illegal activities with this IPT number